2012-12-14 09:59:33
Greater access to cheap vitamin D supplements would improve the health of
at-risk groups, experts say.
The Royal College of Paediatrics and Child Health (RCPCH) says up to 25% of UK
children are vitamin D deficient, leading to a rise in rickets cases.
In the BBC's Scrubbing Up column, the college's Prof Mitch Blair called for
concerted action to tackle the problem.
The government said those with the greatest need already received free
supplements.
The RCPCH said other options to increase vitamin D levels, such as fortifying a
wider range of foods, should be considered.
Half of the UK's white population, and up to 90% of the black and Asian people
in the country are thought to be affected by vitamin D deficiency.
A lack of the nutrient is linked to a higher incidence of diabetes,
tuberculosis, multiple sclerosis as well as rickets - a disease that causes
bones to become soft and deformed.
Dr Barbara Murray said children spend too much time indoors and need "more
sunlight"
The number of cases of rickets has been rising, from 183 in 1996 to 762 in
2011.
In January this year, the chief medical officer for England, Dame Sally Davies,
recommended all pregnant and breastfeeding women, children aged six months to
five-years-old and the over-65s should take vitamin D supplements.
'Short supply'
Writing in Scrubbing Up, Prof Blair said: "Vitamin D can be found in some foods
such as oily fish, eggs and mushrooms - but only 10% of a person's recommended
daily amount is found naturally in food.
"Put bluntly, eating more fish and getting out in the sun a bit more won't make
much of a difference to your vitamin D levels."
The RCPCH is also calling for a public awareness campaign to raise awareness of
the warning signs of vitamin D deficiency and how to prevent it, and more
research into the link between vitamin D deficiency and bone disease.
It says this is needed to help investigations into bone injuries in children.
How much Vitamin D?
Vitamin D does not have a recommended daily intake in the same way as other
vitamins and minerals as it is primarily made by the body rather than consumed
in food.
If you look at the concentration of the vitamin in the blood then levels below
25 nanomoles per litre are a sign of deficiency.
There is still controversy over the optimal level for health. Around 50
nanomoles per litre is argued for good bones, while some experts champion 75
nanomoles per litre for other conditions such as MS and diabetes, although this
remains a source of debate.
Diet is a poor source of the vitamin, although it is in fatty fish, eggs and
fortified foods. However, 10 to 20 minutes of sunlight for light-skinned
people, or more than half an hour for those with darker skins, should be enough
for a week's worth of the vitamin.
The government advises pregnant or breast feeding women and the over-65s to
take a daily supplement containing 10 micrograms of vitamin D. Babies and the
under fives should have daily vitamin D drops, unless they are taking formula
milk.
Prof Blair added: "The government's Healthy Start programme provides vitamins
free to low income families and 'at risk' groups.
"But these vitamins appear to be in short supply and uptake is low. Ensuring
people are aware they're available is crucial."
The college is to produce leaflets in a bid to raise awareness of vitamin D
deficiency among the profession.
In addition, the Scientific Advisory Committee on Nutrition (SACN) is looking
into proposals for further fortification of food and drink, as happens in
countries including the US, Canada and Finland.
'Best placed'
Prof Nicholas Clarke, consultant orthopaedic surgeon at Southampton General
Hospital, said who has been warning of the dangers of vitamin D deficiency
since 2010, said: "I strongly support the use of supplements and widespread
fortification of foods."
Dame Sally said doctors and other health professionals were "best placed" to
give advice on vitamin D.
She added: "The Department of Health has also made sure vitamin D supplements
are available free to pregnant women and young children from low income
families through our Healthy Start scheme.
"Local NHS organisations must make sure those eligible for Healthy Start get
the supplements they're entitled to, and the department continues to work
closely with the NHS on this."